Chapter 33 Obstetrics and Neonatal Care

Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy? A. Increased respiratory depth and decreased respiratory rate B. Increased respiratory rate and decreased respiratory reserve C. Decreased respiratory rate and increased minute volume D. Increased respiratory reserve and decreased oxygen demand

B. Increased respiratory rate and decreased respiratory reserve

A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should: A. administer oral glucose for presumed hypoglycemia and transport B. place her on her side, administer high-flow oxygen, and transport C. insert an oral airway and ventilate her with a bag-valve mask D. elevate her legs to improve brain function and keep her warm

B. place her on her side, administer high-flow oxygen, and transport

An infant is considered to be premature if it: A. is born before 38 weeks' gestation or weighs less than 6 lb B. weighs less than 5 lb or is born before 36 weeks' gestation C. weighs less than 5.5 lb or is born before 37 weeks' gestation D. is born before 40 weeks' gestation or weighs less than 7 lb

B. weighs less than 5 lb or is born before 36 weeks' gestation

If a baby is born at 7:52, the second Apgar score should be calculated at: A. 7:59 B. 7:53 C. 7:57 D. 8:00

C. 7:57

During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? A. Tell the mother not to push and transport her immediately B. Maintain firm pressure to the head until it completely delivers C. Apply gentle pressure to the baby's head as it delivers D. Place your fingers in the vagina to assess for a nuchal cord

C. Apply gentle pressure to the baby's head as it delivers

A history of pelvic inflammatory disease or tubal ligations increase a woman's risk for: A. preeclampsia B. gestational diabetes C. an ectopic pregnancy D. placenta previa

C. an ectopic pregnancy

The umbilical cord: A. carries blood away from the baby via the artery B. separates from the placenta shortly after birth C. carries oxygen to the baby via the umbilical vein D. contains two veins and one large umbilical artery

C. carries oxygen to the baby via the umbilical vein

You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should: A. ask more detailed questions and press the issue until you have a more detailed understanding of the incident B. contact police and remain at the scene until they arrive and escort you to the hospital C. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care D. immediately remove the patient from the environment and transport

C. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should: A. assess his skin color and give free-flow oxygen as needed B. clamp and cut the umbilical cord and keep him warm C. keep him warm and ventilate with a BVM D. begin chest compressions and reassess in 30 seconds

C. keep him warm and ventilate with a BVM

The presence of meconium in the amniotic fluid indicates: A. an expected finding in full-term infants B. that the fetus is at least 4 weeks premature C. that the baby's airway may be obstructed D. that full newborn resuscitation will be needed

C. that the baby's airway may be obstructed

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: A. superior diaphragm B. pubic bone C. xiphoid process D. belly button

D. belly button

Signs and symptoms of preeclampsia include: A. dysuria and constipation B. marked hypoglycemia C. dyspnea and bradycardia D. headache and edema

D. headache and edema

Which of the following statements regarding the placenta is correct? A. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus B. The placental barrier consists of two layers of cells and allows the mother's blood that contains high concentration of oxygen to directly mix with the blood of the fetus C. The placenta provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born D. The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus

A. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus

The vagina and the neck of the uterus comprise the: A. birth canal B. womb C. fundus D. cervix

A. birth canal

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should: A. firmly massage the uterine fundus with a circular motion B. elevate her legs 6 to 8 inches and cover her with a blanket C. place her legs together and position her on her left side D. carefully insert a sterile trauma dressing into her vagina

A. firmly massage the uterine fundus with a circular motion

In contrast to the abruptio placenta, placenta previa: A. may not present with heavy vaginal bleeding B. may present without significant abdominal pain C. is typically associated with severe abdominal pain D. is caused by hypertension or abdominal trauma

A. may not present with heavy vaginal bleeding

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should: A. place her in a left lateral recumbent position B. ventilate her with a bag-valve mask C. carefully place sterile gauze into her vagina D. position her supine and elevate her legs 12 inches

A. place her in a left lateral recumbent position

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A. positive-pressure ventilations B. thorough drying with a towel C. some form of tactile stimulation D. suctioning of the upper airway

A. positive-pressure ventilations

You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child. The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should: A. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient B. call for the police to ensure that patient assessment is carried out C. inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management D. insist that the patient requires proper care and that requires an adequate physical assessment and that you cannot be responsible for the outcome

A. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient

Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breastfeed, the bleeding stops. This occurred because: A. these actions simulate the production of oxytocin and cause uterine contraction B. a portion of the placenta was retained in the uterus C. breastfeeding causes uterine blood vessels to dilate D. uterine massage increases blood flow to the uterus

A. these actions simulate the production of oxytocin and cause uterine contraction